I've spent years exploring health, mental health, and science as a journalist based on the Left Coast. I covered west coast biotech and science for Bloomberg News and contributed to dozens of publications including Bloomberg Business Week, Mother Jones, Salon, Health magazine, Reader’s Digest, Parenting, and the Los Angeles Times. I’m interested in how and why the wealthiest country in the world has such an irrational healthcare system that develops brilliant new therapies while overtreating many and underserving even more. I'm also deeply interested in efforts to make our communities healthier by ensuring that everyone has access to the things that foster good health -- good food, safety and the chance to be physically, politically and socially active.

Scientists Dare To Use The C-Word -- Cure -- As AIDS Meeting Sets To Open In Washington

Kuritzkes and Henrich decided to look for HIV-infected cancer patients who had undergone bone marrow transplants but didn’t use CCR5-negative donors. They wanted to see if HIV levels in the patients’ reservoir of memory T-cells dropped after treatment. They located two patients who fit the bill and had remained on antiretroviral drugs throughout their cancer treatment. The researchers scoured the blood and tissue samples of the patients, using highly sensitive tests to look for any traces of viral RNA. If those levels fell significantly after a transplant, Kuritzke told me, that may signal that transplants from ordinary donors who don’t carry the CCR5 mutation will be sufficient to reduce the HIV reservoirs of patients and make it much easier to find donors. The scientists will report on the experience of these two patients next week at the conference.

Another variation of the Timothy Brown approach is underway now in the Netherlands, where doctors several weeks ago transplanted an HIV-infected cancer patient with umbilical cord blood cells that do carry the CCR5 mutation. The cells were provided by Stemcyte, a cord blood bank based in Covina, California. Lawrence Petz, Stemcyte’s chief executive officer, told me his team had screened 17,000 units of banked cord blood and found 100 with the protective mutation. The doctor who performed the transplant said it was too early yet to know whether the procedure has eradicated the patient’s HIV.

The other approach attacks the problem from a different direction. The powerful drugs used by HIV-infected people do a good job of suppressing levels of the virus and keeping people from developing AIDS symptoms. But they are powerless to deliver a knockout punch against the latent reservoirs of infected memory cells that remain. These cells hide from the drugs, ready to replicate and rebound if the patient ever stops taking medication. Part of the reason they stay hidden is that an enzyme called HDAC keeps them from making the viral RNA they need to replicate Researchers are searching for ways to flush these sleeping pockets of HIV out of their hiding places so they can attack them with antiviral drugs.

In March, a team led by David Margolis at the University of North Carolina showed that an approved Merck cancer drug, Zolinza, can do just that. He gave the drug to six patients and showed that levels of viral RNA expressed in their immune cells rocketed up almost five-fold. In the next study, which may begin in four to six weeks, Margolis plans to test repeated doses of the drug, in conjunction with standard antiretroviral therapy, to see if it can lower the number of infected immune cells. “I don’t expect a cure from this alone but we need to see how far we can get to go on to the next step,” Margolis told me.

The successful treatment of Timothy Brown and deeper understanding of how the virus maintains itself has shifted the mood of researchers. “Five years ago, I would have said a cure was impossible,” said Kuritzkes. “Now I’m not so sure. The odds still favor the virus but what we saw from Timothy Brown gives us reason for cautious optimism.”

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